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Long-term incidence and risk factors of cardiovascular events in Asian populations: systematic review and meta-analysis of population-based cohort studies

Irawati, S., Wasir, R., Schmidt, A. F., Islam, A., Feenstra, T., Buskens, E., Wilffert, B. & Hak, E., 1-Feb-2019, In : Current Medical Research and Opinion. 35, 2, p. 291-299 9 p.

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  • Long-term incidence and risk factors of cardiovascular events in Asian populations

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Background: Scientific studies on cardiovascular disease (CVD) burden and risk factors are predominantly based on short-term risk in Westerner populations, and such information may not be applicable to Asian populations, especially over the longer term. This review aims to estimate the long-term (>10 years) CVD burden, including coronary heart disease (CHD) and stroke, as well as associated risk factors in Asian populations. Methods: PubMed, Embase and Web of Science were systematically searched, and hits screened on: Asian adults, free of CVD at baseline; cohort study design (follow-up >10 years). Primary outcomes were fatal and non-fatal CVD events. Pooled estimates and between-study heterogeneity were calculated using random effects models, Q and I-2 statistics. Results: Overall, 32 studies were eligible for inclusion (follow-up: 11-29 years). The average long-term rate of fatal CVD is 3.68 per 1000 person-years (95% CI 2.84-4.53), the long-term cumulative risk 6.35% (95% CI 4.69%-8.01%, mean 20.13 years) and the cumulative fatal stroke/CHD risk ratio 1.5:1. Important risk factors for long-term fatal CVD (RR, 95% CI) were male gender (1.49, 1.36-1.64), age over 60/65 years (7.55, 5.59-10.19) and current smoking (1.68, 1.26-2.24). High non-HDL-c, and beta- and gamma-tocopherol serum were associated only with CHD (HR 2.46 [95% CI 1.29-4.71] and 2.47 [1.10-5.61] respectively), while stage 1 and 2 hypertensions were associated only with fatal stroke (2.02 [1.19-3.44] and 2.89 [1.68-4.96] respectively). Conclusions: Over a 10 year + follow-up period Asian subjects had a higher risk of stroke than CHD. Contrary to CVD prevention in Western countries, strategies should also consider stroke instead of CHD only.

Original languageEnglish
Pages (from-to)291-299
Number of pages9
JournalCurrent Medical Research and Opinion
Volume35
Issue number2
Publication statusPublished - 1-Feb-2019

    Keywords

  • Asia, cardiovascular disease, coronary heart disease, long-term risk, risk factor, stroke, DENSITY-LIPOPROTEIN CHOLESTEROL, CAUSE-SPECIFIC MORTALITY, 20-YEAR FOLLOW-UP, CORONARY-ARTERY-DISEASE, ALL-CAUSE MORTALITY, BLOOD-PRESSURE, LIFETIME RISK, HEART-DISEASE, CHINESE POPULATION, PACIFIC COHORT

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